Thursday, January 10, 2013

So...

Went to the Mohs surgeon yesterday.

He was a nice guy, very confident. I like confidence in a man who's going to be taking a knife to my face.

He spent the time alternately assuring me that I had nothing to worry about, that his goal was that there not be any visible scarring, and scaring my pants off by telling me that there was no telling how deep or widespread the roots of this carcinoma had gone, but if too much tissue had to be removed, then there was always the option of a good ENT...

I'm not at all good with the whole Lon Chaney, Sr. Phantom of the Opera look.

Surgery's scheduled for next month.

He was a lot better at scaring than he was at reassuring, or maybe I'm just a lot better at being scared than reassured.

64 comments:

Tam , In 2008 I had a cancer surgery every five weeks form feb.14 till sep.(by then I didn't keep tack of dates anymore)I was in treatment till 2010. All of it head and neck. You will have scars, On your face and in you heart. They will heal. So will you. Cry, scream, go to the range and shoot something, it helps. Then kick cancers ass.--- Ray

I'm not a doctor, but as a defense attorney I regularly have to tell my clients things that aren't likely to happen but are nonetheless possible.

As an example, let's say someone has violated the law for the first time by shoplifting a pair of socks from Wal-Mart. Under Virginia law, they could receive a maximum of twelve months in jail. If a judge were to sentence a first-offender with a year in jail for that crime, it would be upheld on appeal. That said, even thirty days (of which, in Virginia, you serve half) would be news throughout the Virginia legal community. The more likely outcome is a night in jail, or community service.

They have to give you worst-case, but when I had to have surgery on my face they were very careful about how they did it in order to avoid scarring. You have to really, really look to see the incision.

MAY YOU GO FROM STRENGTH TO STRENGTHKEEP A POSITIVE FRAME OF MINDDO NOT RUMINATE OVER NEGATIVE "WHAT IFS" YOU HAVE THE SUPPORT GOOD WISHESAND PRAYERS OF LEGIONS OF YOUR FRIENDSWHO DEPEND ON YOU BEING YOU HUG YOUR CRITTERS HAVE SOMETHING NICE TO EATSEE YOUR FAVORITE MOVIE READ YOUR FAVORITE BOOK LISTEN TO YOUR FAVORITEMUSIC SEND 50 ROUNDS OF .45ACP DOWNRANGE GET THEM IN IN THE BLACK IN DECENT GROUPS COMPOSE A "WHAT-THE- HELL-GRAMME" VS A MAJOR INJUSTICESLEEP THE SLEEP OF THE RIGHTEOUS GET SOME REST YOU HAVE A MISSION PIECE OF CAKE!

I've had several growths removed from my face, though none proved to be cancerous. No one can tell where they were, now. Although, with my face, no one cares to look too closely, anyway. Best hopes for a perfect outcome!

Good luck. Don't worry. You'll be fine. My dermatologist says that basal cell carcinoma removals are like getting a tooth pulled. Everyday mundane stuff to a Guy that does it three times a day before breaking for lunch. Worrying wont change the results, because no matter how you look at it the results will be what they are, and chances are they'll be good.

My specialty is OB/perinatal, but I recognize this speech because I do the OB version of it all the time. There are two parts to the pre-procedure "what is going to happen" speech. Part One is titled "What Usually Happens." Part Two is titled "Crazy Freaky Stuff that Almost Never Happens, but My Lawyer Wants Me to Mention."

That's how you get "Walking from the sidwalk to your front door is a piece of cake; you'll be indoors before you know it. Or, you might get crushed by a giant meteorite."

The fact that we devote roughly equal amounts of time to Part One and Part Two does not mean they are equally likely.

Don't stress about the giant meteorite, Tam. It's not going to happen.

I have some experience with a cancer of this type in the area you describe. If I may, Be less concerned with cosmetics and highly concerned with getting it all the first time. The internet allows for a sense of familiarity where none exists. Virtual loss is still loss.

I don't have any scars from the two surgeries I went through. Mind you, I was working on a story involving Heidelburg for the spot in my eyebrow, but I didn't get to use it.

The first surgery was really boring, it did go deeper than he originally though, so I had to go through a second pass on the same day. It was a really long day, most of it spent sitting in the waiting room. Take a couple of books with you.

Sleeping may be a challenge. I recommend you get a week's worth of really good painkillers. Also, your face will probably swell up when you lay down for any extended length of time. I found it really annoying, but not painful.

You should do fine as long as you warn you roomie that pointing and laughing could be unhealthy...

Other folks familiar with the process have already mentioned it, but...

If he scared better than he reassured then his lawyer is a happy man. Don't sweat the meteorite, that date on the calendar is the day you get to put this all behind you and rev the snark-o-meter to max.

In the meantime, suck the marrow out of life. Be a life-i-vore. Gnaw your way through a big hunk of life steak with a heaping side of "OH HELL YEAH!!" and a beer. Not a bull testicle beer, but a good stiff one that bites back so you can kick its ass and suck its beery blood...

I had the Mohs surgery done to the outside of my left nostril a few months ago. My doctor had to go deep and wide to get it all. She had to take a graft from my jawline to close the divot. I was convinced I was going to be scaring children and small animals more than usual for the rest of my days.

You'll go through a process by which the band-aids get smaller and smaller. Then you sleep with a silicone pad taped to the wound site. Then you buy a tube of Mederma scar cream over the counter.

Guess what? 120 days post-op and it's getting difficult to see that there was anything ever done.

It's more of a pain in the ass than a life-altering event. I know it's scary. Trust me. BTDT. But you'll be fine.

I was involved in a few Mohs procedures as a resident, back when we took our Hippocratic Oath from Hippocrates.

In general they go very well. My colleague (above) is entirely correct in his explanation of how risks are discussed.

Something else: Although extirpation of basal cell is the primary goal of Mohs, a good cosmetic result is very important. No surgeon wants their patient sporting the "Phantom of the Opera" look.

If I prescribe you a drug and you end up in the ICU, at follow up we'll discuss what a terrible drug that was for you and how I'll never give it to you again. If you have a surgical complication that leads to a bad outcome, the blame is laid squarely at the surgeon's feet.

No one wants any part of that. No surgeon is going to schedule you for an elective procedure if they're not confident they can put you in a better place than you are now.

Bandages, scars -- not even a regular or cute face defines who you are. Healthy people fear and resist battle scars, but usually deal with them.

At the least, wait to see the size of the mole hill before starting mountain construction.

And if your doctor hasn't mentioned/recommended contacting one or more cancer patient groups or services, kick the scary doc next visit! A local pastor can also be good touchpoint to find support and information.

Having enjoyed the segmenting, rearrangement and bolting of my maxilla a month ago, I can relate to your anxiety. In this litigious age, MDs have to cover their asses, but I think you have every reason to have a very positive outlook, darling. You'll get through this and you'll get better quickly. Meantime, moar beer!

Yeah, don't worry about all that worst-case-scenario stuff. After all, if you believed the "worst case scenario" for the drive to the damn hospital, you'd never leave the house again, would you?

Look at it this way: there's a cinema in your head and, as manager, YOU get to pick which movie they show. So, you could watch Phantom of the Opera, or you could watch something cheerier. You're the boss, Boss. What would you rather see?

In a couple of months, you'll be musing about the minor inconvenience of surgery and challenging people to find the scar. So stop scaring yourself and start making plans about how to treat yourself when it's all over!

"When Chuck Norris goes to sleep at night he keeps a Tam under his pillow for protection."

. . so, like Tam could think of the to-be-removed stuff as a "hidden gusset"? (as per Rachel Lucas' "Chuck Norris Hidden Gusset Award", based on a 1980's ad for Chuck Norris' "action" jeans intended for action and martial arts).

That might be reassuring, I guess, kinda. . No, the analogy doesn't reach that far, for me.

Sorry to read about this troubling odyssey of yours. Our five year old, Dashiell, is fighting a transitional carcinoma, and it's been a real bear. Our thoughts are with you. Next time we drive through (around) Indy on our way to Cincy we'll toot the horn for you.

Tam, may the Lord God Almighty guide the hand of your surgeon so that he cuts just enough, and no further, and that the necessary cutting does no harm to your marvelous snarky visage. In the name of Jesus, that's what I pray.